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Does the Autoimmune Protocol Diet Help Rheumatoid Arthritis?

Many people believe that by changing their diet, they can affect their rheumatoid arthritis and better manage the disease. There are a lot of diets available, some more trendy than others. Should you be following the autoimmune protocol diet?

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There’s the gluten-free diet, ketogenic diet, vegan diet, Zone diet, South Beach diet, and more. If you listen to the news or are active on social media, you likely have heard of these diets and know people who tried them.

Among people with rheumatoid arthritis (RA), there is a popular notion that RA can be managed with diet, thereby skipping the undesirable side effects associated with certain medication. There is even an autoimmune protocol (AIP) diet, which by its name alone makes you think you should be on board.

What Is the AIP Diet? The Autoimmune Protocol Diet Explained

In autoimmune diseases, the body mistakenly attacks its own tissues, causing damage. The autoimmune protocol diet works on inflammation in the gut, which is thought to be associated with autoimmune disease. Specifically, the AIP diet is thought to heal the immune system and the gut mucosa (lining), impacting inflammatory diseases, such as rheumatoid arthritis.

Is the AIP Diet the Same As the Paleo Diet?

The autoimmune protocol diet is considered the same as the Paleo diet by some. You will also see AIP called a “version” of the Paleo diet. Some say it is a stricter version of the Paleo diet. The principle behind the AIP diet is that autoimmune conditions are caused by “leaky gut” or altered intestinal permeability. In leaky gut, food leaks through tiny holes in the gut, provoking a response — actually an overreaction — by the immune system.

With the AIP diet, you eat foods that are rich in nutrients and steer clear of foods that are considered pro-inflammatory. Through diet, the goal is to not provoke an autoimmune response by the immune system. Summary of goals: Avoid irritating the gut with foods, heal holes in the gut, and reduce inflammation and other symptoms of autoimmune disease.

How the Autoimmune Protocol Diet Was Developed

The autoimmune protocol diet has been attributed to Loren Cordain, PhD, a scientist who discovered that certain foods can sometimes trigger inflammation in people with autoimmune disease. Author Robb Wolf outlined the autoimmune protocol in his book, The Paleo Solution, introducing it as an elimination diet. Sarah Ballantyne, PhD, (also known as The Paleo Mom) became interested in the autoimmune protocol, researched the science behind it, and wrote about it in her book, The Paleo Approach. Dr. Ballantyne is considered a leading expert on the autoimmune protocol.

Does the Autoimmune Protocol Diet Work for People With RA?

Researchers have been looking into the role of diet in leaky gut and autoimmune disease since at least 2012, and more current research suggests that, in some people, leaky gut may be linked to the development of autoimmune disease. But there are still no conclusive clinical studies with regard to the role of diet in leaky gut and autoimmune disease.

According to an article published in May 2014 in the journal FEBS Letters, “Rheumatoid arthritis is a multifactorial disease that involves both genetic and environmental factors. Among genetic factors, human leukocyte antigen (HLA) alleles provide the strongest risk, while among environmental factors, smoking and infections are involved. A role of hormones and changes in immune system during aging are also associated with pathogenesis of rheumatoid arthritis. All the factors that influence RA also impact the gut microbial composition. Gut microbiome provides a link between all the factors that influence RA. An individual may harbor a core gut microbiome and certain species may contract or expand depending on the exposure to various environmental factors, thus influencing the immune system locally in the gut as well as adaptive immune system.”

There Appears to Be Gut Involvement in Rheumatoid Arthritis

But still, there is no specific diet that has been proven to help RA. The impact of diet on RA remains theoretical. It’s trial-and-error at best. Essentially it’s an elimination diet whereby you eliminate foods regarded as inflammatory and reintroduce them into your diet over time to see their effect on you individually. That’s the best we have at this stage because nothing about diet has been proven to help RA patients collectively.

A small study published in November 2017 in the journal Inflammatory Bowel Diseases concluded that the autoimmune protocol can have an effect on inflammatory bowel disease (IBD). There were 15 patients with either Crohn’s disease or ulcerative colitis enrolled in the study. They took six weeks to phase out the disallowed foods in the autoimmune protocol, followed by five weeks maintaining the protocol. Eleven of the 15 study participants had a complete remission. Great news for sure. But 15 is a very small study group — and there was no control group, and the study was not randomized. That said, to date this is the best clinical study we have for the autoimmune protocol diet. There is no such published study for RA. It’s lacking and it’s needed.